ClinicalTrials.gg
CompletedNCT03309579Updated Nov 6, 2024

SAHaRA: A Randomized Controlled Trial

An interventional study of Liberal RBC Transfusion Strategy and Restrictive RBC Transfusion Strategy in Subarachnoid Hemorrhage, Aneurysmal, sponsored by Ottawa Hospital Research Institute. Completed at 23 sites in 3 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-11-06.

Sponsored by Ottawa Hospital Research Institute · Not applicable, Interventional, and Treatment

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Phase
Not applicable
Study type
Interventional
Enrollment
742
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-14

Among 27 studies in Subarachnoid Hemorrhage with a site in Canada — 4 open to participants now, 5 under way, none of them phase 3. Subarachnoid Hemorrhage · Canada.

Enrollment
2nd of 23
742 · median 73
Started
2018
the only one that year
No phase
6 of 27
none open now
Registered
19th of 27
by date
Lead sponsor
2 of 27
Ottawa Hospital Research Institute

Among the 27 studies in Subarachnoid Hemorrhage with a site in Canada, this one is the 2nd largest by enrollment of the 23 interventional ones that give a count, is the only one that started in 2018, is one of 6 with no phase, and was the 19th registered.

Subarachnoid Hemorrhage

510 studies on the registry are indexed under Subarachnoid Hemorrhage; 128 are open to participants now.

Browse Subarachnoid Hemorrhage studies →

Open to participants now

4 of the 27 studies in Subarachnoid Hemorrhage with a site in Canada are open now. Recruiting first, the newest first:

All 4 open studies →

A study can be open while its sites in Canada have not opened yet or have stopped. Only those recruiting at a site in Canada →

Who these studies take

Of the 89 Subarachnoid Hemorrhage studies recruiting now, 56 (63%) set no upper age limit and 4 (4%) stop at 75 or younger; 7 take children under 18; 7 take healthy volunteers.

This study: 18 Years and older · all sexes · no healthy volunteers.

The full table on the hub →

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02

Study summary

The SAHaRA trial will clarify the role of treating anemia with Red Blood Cell (RBC) transfusion in a unique and vulnerable patient population, and determine whether that impacts on functional outcomes and mortality. It will guide best practice standards and clarify the optimal RBC transfusion strategy in patients with aSAH.

Read the detailed description

We hypothesize that in adult patients suffering from aSAH and anemia, a liberal RBC transfusion strategy as compared to a restrictive RBC transfusion strategy decreases the combined rate of death and severe disability at 12 months (using the modified Rankin Scale)

03

Conditions studied

  • Subarachnoid Hemorrhage, Aneurysmal

Keywords

  • Aneurysmal subarachnoid hemorrhage (aSAH)
  • Red Blood Cell Transfusion (RBC)
  • Vasospasm
  • Intracranial Hemorrhages
  • Cardiovascular Diseases
04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Age ≥18 years old at time of SAH
  2. First ever episode of aneurysmal SAH
  3. Diagnosis of aSAH as confirmed by treating physician (eg: neurosurgeon or neuro- interventionalist) and supported by blood in subarachnoid space (e.g. cranial imaging or cerebrospinal fluid positive for xanthochromia, surgical visualization) that is the result of a ruptured aneurysm (e.g. direct visualization, cranial imaging or catheter angiogram)
  4. ≤100g/L within 10 days following aSAH (defined by first day of hospital presentation)

Exclusion criteria

Exclusion Criteria:

  1. Physician and or family decision to withdraw/withhold active medical care at time of enrolment
  2. Active bleeding with hemodynamic instability at time of enrolment
  3. Patients with or known objection to blood transfusions
  4. SAH due to mycotic aneurysm, infundibulum and vascular malformations.
Terms in these criteria, in plain language(2)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
742 participants (actual)

Study arms

  • Experimental
    Liberal RBC Transfusion Strategy

    Hemoglobin value of ≤100g/L

    Other: Liberal RBC Transfusion Strategy

  • Active comparator
    Restrictive RBC Transfusion Strategy

    Hemoglobin value of ≤80g/L

    Other: Restrictive RBC Transfusion Strategy

Interventions

  • OtherLiberal RBC Transfusion Strategy

    RBC transfusion is triggered by a Hemoglobin value of ≤100g/L

  • OtherRestrictive RBC Transfusion Strategy

    Optional RBC transfusion is triggered by a Hemoglobin value of ≤80g/L

06

What researchers measure

Primary outcomes

  1. Modified Rankin Scale (mRS)

    The Modified Rankin Scale (mRS) is a functional outcome measure in stroke. The interview consists of five sections: Constant Care, Assistance to Attend to Bodily Needs/For Walking, Assistance to Look After Own Affairs, Usual Duties and Activities and Symptoms as a Result of Stroke. The scale is scored from 0 reporting no symptoms at all, to 5 reporting severe disability. Death is indicated by a score of 6.

    Time frame: 12 months post

Secondary outcomes

  1. Functional Independence Measure (FIM)

    The Functional Independence Measure (FIM) assesses the level of a patient's disability considering the amount of support needed to care for them.Items are scored on the basis of how much assistance is required for the individual to carry out activities of daily living. The FIM is comprised of 18 items, grouped into 2 subscales - motor and cognition. Each item is scored on a 7 point ordinal scale, ranging from 1 to 7. The 2 subscales are then added to give a total FIM score between 18 and 126. The higher the score, the more independent the patient is in performing activities of daily living.

    Time frame: 12 months post

  2. EuroQOL Quality of Life Scale (EQ5D)

    The EQ-5D measures generic health status. There are 5 dimensions: Mobility, Self-care, Usual Activities, Pain/Discomfort and Anxiety/Depression which are answered by 5 Problem Levels: None, Slight, Moderate, Severe and Unable. The result is a 5 digit number, 11111 indicating no problem in any dimension to 55555 indicating unable to complete in all dimensions. Quality of life is also assessed on a visual analog scale reported from 0 being the worst imaginable health status to 100 as the best imaginable health status.

    Time frame: 12 months post

  3. Red Blood Cell Transfusions

    The total number of red blood cell transfusions received.

    Time frame: up to 21 days

  4. Daily Hemoglobin

    The lowest daily hemoglobin values.

    Time frame: up to 21 days

  5. Transfusion-related Complications

    Complications such as Acute Respiratory Distress Syndrome (ARDS), cardiovascular failure, cardiac ischemia, deep venous thrombosis, pulmonary embolism, sepsis, and septic shock.

    Time frame: up to 28 days

  6. Delayed Cerebral Ischemia and Vasospasm

    The incidence and severity of delayed cerebral ischemia and vasospasm.

    Time frame: up to 28 days

  7. Cerebral Infarction

    The incidence of cerebral infarctions.

    Time frame: up to 28 days

  8. Mechanical Ventilation

    If required, the duration of mechanical ventilation.

    Time frame: up to 21 days

  9. Length of Stay

    The length of ICU or hospital stay.

    Time frame: 12 months post

  10. Mortality

    The number of deaths.

    Time frame: 12 months post

07

Study locations

23 sites
  • University of Colorado School of Medicine
    Aurora, Colorado 80045, United States
  • Emory University School of Medicine
    Atlanta, Georgia 30322, United States
  • Rush University Medical Center
    Chicago, Illinois 60612, United States
  • Nepean Hospital
    Kingswood, New South Wales, Australia
  • Prince of Wales Hospital
    Randwick, New South Wales, Australia
  • Royal North Shore Hospital
    St. Leonards, New South Wales, Australia
  • Royal Brisbane & Women's Hospital
    Herston, Queensland, Australia
  • The Alfred
    Melbourne, Victoria, Australia
  • Foothills Medical Center
    Calgary, Alberta, Canada
  • University of Alberta Hospital
    Edmonton, Alberta, Canada
  • Vancouver General Hospital
    Vancouver, British Columbia, Canada
  • Royal Jubilee Hospital
    Victoria, British Columbia, Canada
  • Winnipeg Health Sciences Center
    Winnipeg, Manitoba, Canada
  • Nova Scotia Health Authority
    Halifax, Nova Scotia, Canada
  • Hamilton Health Sciences Center
    Hamilton, Ontario, Canada
  • Kingston Health Sciences Centre
    Kingston, Ontario, Canada
  • London Health Sciences Center
    London, Ontario, Canada
  • Shane English
    Ottawa, Ontario K1Y 4E9, Canada
  • Sunnybrook Research Institute
    Toronto, Ontario, Canada
  • Centre hospitalier de l'Université de Montréal
    Montréal, Quebec, Canada
  • Montreal Neurological Institute and Hospital
    Montréal, Quebec, Canada
  • Centre hospitalier universitaire de Québec-Université Laval
    Québec City, Quebec, Canada
  • Centre hospitalier universitaire de Sherbrooke
    Sherbrooke, Quebec, Canada
08

References and documents

Publications

  • Carson JL, Stanworth SJ, Dennis JA, Trivella M, Roubinian N, Fergusson DA, Triulzi D, Doree C, Hebert PC. Transfusion thresholds for guiding red blood cell transfusion. Cochrane Database Syst Rev. 2021 Dec 21;12(12):CD002042. doi: 10.1002/14651858.CD002042.pub5. PubMed 34932836 ↗

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Feb 2018 to primary completion in Jul 2024, 76 months.

Of 57 non-industry interventional studies with no phase under Subarachnoid Hemorrhage, half reached primary completion within 38 months of starting (the median), counting those still running; a quarter within 24 and three quarters within 62. This study's 76 months is above that.

Counting every sponsor, half of 67 studies reached it within 32 months; a quarter within 20 and three quarters within 60.

How these figures are worked out, and which studies are left out of them.

Registered
Oct 10, 2017
First posted
Oct 13, 2017
StartActual
Feb 12, 2018
Primary completionActual
Jul 10, 2024
CompletionActual
Aug 22, 2024
Last update
Nov 6, 2024
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Nov 6, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03309579
Collaborators
Canadian Institutes of Health Research (CIHR)
Responsible party
Sponsor
First posted
Oct 13, 2017
Start date
Feb 12, 2018
Primary completion
Jul 10, 2024
Completion
Aug 22, 2024
Last update
Nov 6, 2024

Study contacts

Shane English, MD MSc FRCPC
principal investigator · Ottawa Hospital Research Institute

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Nov 2024. You cannot join it, but the record below documents what was studied.

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